OP0262 PREVALENCE AND PREDICTORS OF ACHIEVING SUSTAINED REMISSION IN PSORIATIC ARTHRITIS
Authors: O. Palsson, J. T. Einarsson, J. K. Wallman, T. Love, B. Gudbjornsson, M. C. Kapetanovic
Journal: Annals of the Rheumatic Diseases (2022)

Background Increased availability and a wide selection of b/tsDMARDs with different mode of action has made long-term remission a realistic treatment goal in psoriatic arthritis. Objectives To estimate the prevalence and possible predictors of sustained remission in patients with psoriatic arthritis (PsA) treated with biologic or targeted synthetic disease-modifying anti-rheumatic drugs (bDMARD/tsDMARD) in Sweden. Methods All patients initiating treatment with bDMARDs or tsDMARDs for PsA in Sweden and registered in the national Swedish Rheumatology Quality Register (SRQ) were included. Data on disease and treatment characteristics from the start of the first b/tsDMARD (baseline) and all registered subsequent visits were extracted from SRQ. Sustained remission (SR) was defined as DAS28-CRP ≤ 2.6, DAPSA28 ≤ 4 or the evaluator’s global assessment of disease activity (0-4 on a Likert scale) = 0, during at least two consecutive visits over at least six months. To compensate for factors that may temporarily raise disease activity measures, such as concurrent infections, one visit with higher disease activity was allowed if the treatment regimen was not altered at that point and if less than two years between adjacent visits in remission. A sensitivity analysis was performed with a more stringent SR definition, not allowing any such visits with higher disease activity. Logistic regression was used to identify possible predictors of SR. Results 5 459 PsA patients with 50 811 visits were included in the analysis. According to DAS28-CRP, 78% of patients achieved a state of remission at some point, and 49% achieved SR at least once. When the more stringent DAPSA28 remission criteria were applied, 27% of patients reached a state of remission at some point, and 11% ever achieved SR. Corresponding figures using the evaluator’s global assessment were 64% and 34% for ever reaching remission or SR, respectively (Figure 1). The sensitivity analysis rendered similar results with a ≤3% difference from the main results for all outcomes. Higher age at start of the first b/tsDMARD therapy was associated with a lower likelihood of SR, but males were significantly more likely to achieve SR than females (OR 1,79-2,63 for reaching SR depending on the remission criteria used). Figure 1. Proportion of patients achieving sustained and non-sustained remission at any point after SRQ registration. Conclusion Despite increased availability and a wider selection of b/tsDMARDs with different modes of action, a considerable proportion of PsA patients receiving such treatments never achieve a state of remission, and less than half ever achieve a more extended period of sustained remission. Males are more likely than females to enter sustained remission. Disclosure of Interests Olafur Palsson: None declared, Jon Thorkell Einarsson: None declared, Johan K Wallman Consultant of: Consultancy fees from AbbVie, Amgen, Celgene, Eli Lilly and Novartis (unrelated to the present work)., Thorvardur Love: None declared, Björn Gudbjornsson Speakers bureau: Lecture fee from Amgen and Novartis (unrelated to the present work)., Meliha C Kapetanovic: None declared